Changes in PINCER measures during the pandemic

Pharmacist-led information technology intervention (PINCER) is an effective way to reduce errors in prescription and medication monitoring which are responsible for a large proportion of adverse drug events. This is achieved through the monitoring of 12 PINCER measures.

The purpose of this notebook is observe changes in adherence to each of the PINCER measures at the practice level during the pandemic. For each of these measures we provide a link to the codelist containing all the codes used for that measure, a description of what the measure is and a brief overview of why the measure is important. A summary of the number of events for each measure is produced and monthly rates of recorded activity for each measure is plotted as a decile chart.

The 12 PINCER measures include:

There are also a set of composite indicators which indicate the number of people with 1 or more of each of the broad measure categories:

Gastrointestinal (GI) Bleed Indicators

Age 65+, on oral NSAID without gastroprotection (GI_P3A)

H/O peptic ulcer, on oral NSAID without gastroprotection (GI_P3B)

H/O peptic ulcer, on OAC without gastroprotection (GI_P3C)

On OAC and oral NSAID (GI_P3D)

On OAC and antiplatelet without gastroprotection (GI_P3E)

On aspirin and antiplatelet without gastroprotection (GI_P3F)

Monitoring Indicators

Age 75+, on ACEI or loop, no renal function/electrolytes test (MO_P13)

Methotrexate audit (MO_P15)

On methotrexate without recorded full blood count

On methotrexate without recorded liver function test

On lithium without recent lithium test (MO_P17)

On amiodarone without recent thyroid function test (MO_P18)

Other Indicators

Asthma and non-selective BB (AS_P3G)

Heart failure and oral NSAID (HF_P3I)

eGFR <45 and oral NSAID (KI_P3K)

Composite Indicators

GI Bleed Composite Indicator

Monitoring Composite Indicator]

Other Composite Indicator

Combined Composite Indicator